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Indian Journal of Dermatology
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E-IJD ORIGINAL ARTICLE
Year : 2015  |  Volume : 60  |  Issue : 5  |  Page : 519

Acral vitiligo and lichen sclerosus - Association or a distinct pattern?: A clinical and histopathological review of 15 cases


Visakha Institute of Skin and Allergy, Visakhapatnam, Andhra Pradesh, India

Correspondence Address:
Venkat Ratnam Attili
Consultant Dermatologist and Dermatopathologist, Visakha Institute of Skin and Allergy, Marripalem, Visakhapatnam - 530 018, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.164411

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Background: Acral or acrofacial vitiligo (AFV) with bilateral lesions over the extremities and face is considered as a transitional form that may progress to generalized vitiligo. Oral and genital mucosal lesions are often integral to this pattern. Lichen sclerosus (LS) in a milder expression, results in oral and genital vitiligoid depigmentation without textural changes and thus needs to be differentiated from AFV. Materials and Methods: We reviewed 217 cases of AFV recorded over a period of 12 years. Results: One hundred and sixteen cases had associated oral/genital lesions. Among these, 15 patients demonstrated typical clinical as well as histological features of LS. Discussion: Coexistence of typical LS essentially among oral and genital lesions of acral vitiligo suggests that acral vitiligo might be a distinct sub-group of NSV. Since both the diseases have an autoimmune basis, the co-existence may be explained by epitope spreading, as a result of interface dermatitis seen in vitiligo. In addition, the possibility of a common genetic predisposition needs to be explored.


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